Analysing efficacy of low-dose oral minoxidil, topical minoxidil, and platelet-rich plasma with topical minoxidil combination in patients with androgenetic alopecia: a randomized controlled observer blinded trial

Androgenetic alopecia (AGA) is commonly treated with topical minoxidil, while platelet-rich plasma (PRP) and oral minoxidil offer alternative options. To compare the efficacy and safety of low-dose oral minoxidil (group 1) (G1), topical minoxidil (group 2) (G2), and PRP with topical minoxidil (group 3) (G3) in AGA. Seventy-five participants were randomly assigned to three treatment groups (n = 25),. Clinical and videodermoscopic assessments were performed at pre-scheduled intervals over 32 weeks, which was completed by 60 patients. At 32 weeks, 25% of patients in groups 1 and 3, and 10% in group 2 showed one grade improvement in AGA severity (p = 0.62). The median percentage increase in terminal hair density was 47.5 in G1, 48 in G2, and 57 in G3 at week 32 favoring G3 over G1 (p = 0.03) and G2 (p = 0.02). Median percentage decrease in vellus hair density was 26 in G1, 21 in G2, and 19 in G3, favoring G1 over G3 (p = 0.03), All 3 groups demonstrated a significant decrease in hair diameter diversity by 32 weeks, with no intergroup variation. The major side effects noted in G1 were headaches (20%), dizziness (15%), and pedal edema (5%). Scalp itching and dryness was observed in 75% of patients after topical minoxidil. Transient pain was observed in all patients during PRP procedure, along with minimal bleeding and dizziness in 15% and 5% respectively. Side effects experienced in all 3 groups were mild and were tolerated by most of the patients. The study emphasizes low-dose oral minoxidil as an effective alternative to topical minoxidil and also suggests the benefits of combining topical minoxidil with PRP.